Progress in the management of head injury
Three 1‐year surveys of head injury management spanning a 9‐year period in a single regional centre are presented, There was a reduction in total numbers of head injury admissions after guidelines for admission and referral were implemented. More liberal use of computed tomography resulted in detect...
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| Veröffentlicht in: | British journal of surgery 1992-01, Vol.79 (1), p.60-64 |
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| container_end_page | 64 |
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| container_title | British journal of surgery |
| container_volume | 79 |
| creator | Miller, J. D. Jones, P. A. Dearden, N. M. Tocher, J. L. |
| description | Three 1‐year surveys of head injury management spanning a 9‐year period in a single regional centre are presented, There was a reduction in total numbers of head injury admissions after guidelines for admission and referral were implemented. More liberal use of computed tomography resulted in detection of a greater number of intracranial haematomas with the majority detected in non‐comatose patients. The early mortality rate in severe head injury fell from 45 per cent to 34 per cent despite referral of large numbers of patients with multiple injuries and a substantial proportion (12per cent) of patients aged more than 70 years in whom outcome did not improve. Total occupied bednights and bednights occupied per surviving patient with severe head injury fell over the period of study. Care for patients with significant head injury should be based on regional neurosurgical units associated with trauma services. |
| doi_str_mv | 10.1002/bjs.1800790122 |
| format | Article |
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D. ; Jones, P. A. ; Dearden, N. M. ; Tocher, J. L.</creator><creatorcontrib>Miller, J. D. ; Jones, P. A. ; Dearden, N. M. ; Tocher, J. L.</creatorcontrib><description>Three 1‐year surveys of head injury management spanning a 9‐year period in a single regional centre are presented, There was a reduction in total numbers of head injury admissions after guidelines for admission and referral were implemented. More liberal use of computed tomography resulted in detection of a greater number of intracranial haematomas with the majority detected in non‐comatose patients. The early mortality rate in severe head injury fell from 45 per cent to 34 per cent despite referral of large numbers of patients with multiple injuries and a substantial proportion (12per cent) of patients aged more than 70 years in whom outcome did not improve. Total occupied bednights and bednights occupied per surviving patient with severe head injury fell over the period of study. Care for patients with significant head injury should be based on regional neurosurgical units associated with trauma services.</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.1800790122</identifier><identifier>PMID: 1737281</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Bristol: John Wiley & Sons, Ltd</publisher><subject>Aged ; Biological and medical sciences ; Cerebral Hemorrhage - diagnostic imaging ; Coma - etiology ; Craniocerebral Trauma - diagnostic imaging ; Craniocerebral Trauma - mortality ; Craniocerebral Trauma - therapy ; Hematoma - diagnostic imaging ; Humans ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Length of Stay ; Medical sciences ; Skull Fractures - diagnostic imaging ; Tomography, X-Ray Computed ; Trauma Severity Indices ; Traumas. 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D.</creatorcontrib><creatorcontrib>Jones, P. A.</creatorcontrib><creatorcontrib>Dearden, N. M.</creatorcontrib><creatorcontrib>Tocher, J. L.</creatorcontrib><title>Progress in the management of head injury</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Three 1‐year surveys of head injury management spanning a 9‐year period in a single regional centre are presented, There was a reduction in total numbers of head injury admissions after guidelines for admission and referral were implemented. More liberal use of computed tomography resulted in detection of a greater number of intracranial haematomas with the majority detected in non‐comatose patients. The early mortality rate in severe head injury fell from 45 per cent to 34 per cent despite referral of large numbers of patients with multiple injuries and a substantial proportion (12per cent) of patients aged more than 70 years in whom outcome did not improve. Total occupied bednights and bednights occupied per surviving patient with severe head injury fell over the period of study. Care for patients with significant head injury should be based on regional neurosurgical units associated with trauma services.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cerebral Hemorrhage - diagnostic imaging</subject><subject>Coma - etiology</subject><subject>Craniocerebral Trauma - diagnostic imaging</subject><subject>Craniocerebral Trauma - mortality</subject><subject>Craniocerebral Trauma - therapy</subject><subject>Hematoma - diagnostic imaging</subject><subject>Humans</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Length of Stay</subject><subject>Medical sciences</subject><subject>Skull Fractures - diagnostic imaging</subject><subject>Tomography, X-Ray Computed</subject><subject>Trauma Severity Indices</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkM1PwzAMxSMEGmNw5YbUA0LiUHAS2iZHmNhgmgYIENwiN023jn6MphXsvydo1Xay7Pd7lv0IOaVwRQHYdby0V1QARBIoY3ukT3kY-IyGYp_0wc19yhk_JEfWLgEoh4D1SI9GPGKC9snlc13Na2Otl5VeszBegSXOTWHKxqtSb2EwccqyrdfH5CDF3JqTrg7I--j-bfjgT5_Gj8Pbqa95KJiPMtWIKIXQTMZBoEEKEIkwUUxTDESi0xTjVCdAMUF2k4RSi9iJhkPMoogPyMVm76quvltjG1VkVps8x9JUrVXubuAhCx141oFtXJhEreqswHqtut-cft7paDXmaY2lzuwWC2gIFITD5Ab7yXKz3m0B9Z-vcvmqXb7qbvK665zX33gz25jfrRfrLxW6KwL1MRur6Qg-5YxP1Av_A1vLfIc</recordid><startdate>199201</startdate><enddate>199201</enddate><creator>Miller, J. D.</creator><creator>Jones, P. A.</creator><creator>Dearden, N. M.</creator><creator>Tocher, J. 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L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3682-a9fcaaa988c29b55c09808d8e7b1fa58dcffabfcd01ada24d69c8b7b1e30b2773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cerebral Hemorrhage - diagnostic imaging</topic><topic>Coma - etiology</topic><topic>Craniocerebral Trauma - diagnostic imaging</topic><topic>Craniocerebral Trauma - mortality</topic><topic>Craniocerebral Trauma - therapy</topic><topic>Hematoma - diagnostic imaging</topic><topic>Humans</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Length of Stay</topic><topic>Medical sciences</topic><topic>Skull Fractures - diagnostic imaging</topic><topic>Tomography, X-Ray Computed</topic><topic>Trauma Severity Indices</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miller, J. D.</creatorcontrib><creatorcontrib>Jones, P. A.</creatorcontrib><creatorcontrib>Dearden, N. M.</creatorcontrib><creatorcontrib>Tocher, J. L.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miller, J. D.</au><au>Jones, P. A.</au><au>Dearden, N. M.</au><au>Tocher, J. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Progress in the management of head injury</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>1992-01</date><risdate>1992</risdate><volume>79</volume><issue>1</issue><spage>60</spage><epage>64</epage><pages>60-64</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Three 1‐year surveys of head injury management spanning a 9‐year period in a single regional centre are presented, There was a reduction in total numbers of head injury admissions after guidelines for admission and referral were implemented. More liberal use of computed tomography resulted in detection of a greater number of intracranial haematomas with the majority detected in non‐comatose patients. The early mortality rate in severe head injury fell from 45 per cent to 34 per cent despite referral of large numbers of patients with multiple injuries and a substantial proportion (12per cent) of patients aged more than 70 years in whom outcome did not improve. Total occupied bednights and bednights occupied per surviving patient with severe head injury fell over the period of study. Care for patients with significant head injury should be based on regional neurosurgical units associated with trauma services.</abstract><cop>Bristol</cop><pub>John Wiley & Sons, Ltd</pub><pmid>1737281</pmid><doi>10.1002/bjs.1800790122</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-1323 |
| ispartof | British journal of surgery, 1992-01, Vol.79 (1), p.60-64 |
| issn | 0007-1323 1365-2168 |
| language | eng |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Aged Biological and medical sciences Cerebral Hemorrhage - diagnostic imaging Coma - etiology Craniocerebral Trauma - diagnostic imaging Craniocerebral Trauma - mortality Craniocerebral Trauma - therapy Hematoma - diagnostic imaging Humans Injuries of the nervous system and the skull. Diseases due to physical agents Length of Stay Medical sciences Skull Fractures - diagnostic imaging Tomography, X-Ray Computed Trauma Severity Indices Traumas. Diseases due to physical agents |
| title | Progress in the management of head injury |
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